Provider Demographics
NPI:1518334614
Name:FALKENBERG, ALLISON EMILY (AMFT)
Entity Type:Individual
Prefix:MS
First Name:ALLISON
Middle Name:EMILY
Last Name:FALKENBERG
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 239
Mailing Address - Street 2:
Mailing Address - City:RICHVALE
Mailing Address - State:CA
Mailing Address - Zip Code:95974
Mailing Address - Country:US
Mailing Address - Phone:530-822-4125
Mailing Address - Fax:530-822-4127
Practice Address - Street 1:1229 BROADWAY STREET
Practice Address - Street 2:
Practice Address - City:RICHVALE
Practice Address - State:CA
Practice Address - Zip Code:95974
Practice Address - Country:US
Practice Address - Phone:530-822-4125
Practice Address - Fax:530-822-4127
Is Sole Proprietor?:No
Enumeration Date:2015-08-25
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
CAAMFT122059106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)